血清25-羟基维生素D与EV71感染手足口病患儿Th1/Th2细胞因子及病情进展关系研究

Study on the Relationship Between Serum 25-Hydroxyvitamin D and Th1/Th2 Cytokines and Disease Progression in Children with Hand,Foot,and Mouth Disease Infected with EV71

目的血清25-羟基维生素D[25-(OH)D]与肠道病毒71型(EV71)感染手足口病患儿辅助性T(Th)1/Th2细胞因子及病情进展的关系研究。方法选择2020年10月至2023年10月在我院就诊的135例EV71感染手足口病患儿作为研究对象,依据病情严重程度分为普通型组(n=95)、重型组(n=40),对比两组血清25-(OH)D、Th1/Th2细胞因子[血清白细胞介素-2(IL-2)、肿瘤坏死因子-α(TNF-α)、血清IL-6]水平,Pearson相关性分析血清25-(OH)D、Th1/Th2细胞因子的关系,多因素Logistic回归模型探讨血清25-(OH)D与病情进展的关系。结果两组血清25-(OH)D水平比较,重型组更低,血清IL-2、TNF-α、IL-6水平比较,重型组更高(P<0.05);血清25-(OH)D与IL-2/TNF-α/IL-6水平负相关(r=-0.344、-0.344、-0.424,P均<0.05);重型组血清25-(OH)D、体液免疫IgG水平及个人卫生习惯良好比例低于普通型组,手足口病病史与白细胞(中性粒细胞)计数升高比例高于普通型组(P<0.05);血清25-(OH)D为患儿病情进展的保护因素(P<0.05),手足口病史、CRP升高为患儿病情进展独立危险因素(P<0.05)。结论血清25-(OH)D与EV71感染手足口病患儿IL-2、TNF-α、IL-6水平均呈负相关,且血清25-(OH)D是EV71感染手足口病患儿病情进展的保护因素,应重视对患儿血清25-(OH)D水平的动态追踪并合理补充维生素D。

Objective To investigate relationship between serum 25-hydroxyvitamin D[25-(OH)D]and helper T(Th)1/Th2 cytokines and disease progression in children with enterovirus 71(EV71)infection of hand,foot,and mouth disease.Methods From October 2020 to October 2023,among the EV71 infected children with hand,foot,and mouth disease admitted to our hospital 135 cases were selected for analysis.They were divided into normal group(n=95)and severe group(n=40)based on the severity of the condition.Serum 25-(OH)D were compared.Th1/Th2 cytokines[serum interleukin-2(IL-2),tumor necrosis factor alpha(TNF alpha),serum IL-6]were analyzed using Pearson correlation analysis to explore relationship between serum 25-(OH)D and Th1/Th2 cytokines.The relationship between serum 25-(OH)D and disease progression was analyzed using univariate and multivariate Logistic regression models.Results Comparison of serum 25-(OH)D between two groups,with severe group having lower levels and serum IL-2,IL-6 and TNF-α.Compared to control group,IL-6 was higher in severe group(P<0.05).Serum 25-(OH)D and IL-2/TNF-α/IL-6 was negatively correlated(r=-0.344,-0.344,-0.424,all P<0.05).The proportion of serum 25-(OH)D,humoral immune IgG,and good personal hygiene habits in severe group was lower than that in the common type group.The proportion of history of hand,foot and mouth disease and increased white blood cell(neutrophil)count was higher in the severe group than in the common type group(P<0.05).Serum 25-(OH)D was a protective factor for the progression of patient s condition(P<0.05),while a history of hand,foot,and mouth disease and elevated CRP were independent risk factors for the patient s condition progression(P<0.05).Conclusion Serum 25-(OH)D is associated with IL-2 in children with hand,foot,and mouth disease infected with EV71.TNF-αand IL-6 are negatively correlated,and serum 25-(OH)D is a protective factor for the progression of EV71 infection in children with hand,foot,and mouth disease.It is important to pay attention to the dynamic tracking of serum 25-(OH)D in children and supplement vitamin D reasonably.